Introducing an E-learning Solution for Medical Education in Liberia
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Walsh S, et al. Introducing an E-learning Solution for Medical
Education in Liberia. Annals of Global Health. 2018; 84(1),
pp. 190–197. DOI: https://doi.org/10.29024/aogh.21
ORIGINAL RESEARCH
Introducing an E-learning Solution for Medical Education
in Liberia
S. Walsh*, M.R. de Villiers* and V.K. Golakai†
Background: The Ebola virus epidemic and civil war in Liberia left the country in need of strengthen-
ing the health workforce. E-learning in medical education provides relevant learning opportunities for
students, develops faculty competencies, and assists with the retention of healthcare workers. The
Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI), the College of Health
and Life Sciences (COHLS) at the University of Liberia (UL), and the Health Resources and Services Admin-
istration (HRSA) formed a partnership to create an e-learning solution for the COHLS.
Objective: This article outlines the implementation of an e-learning solution for the COHLS in Monrovia,
and describes the challenges met, the key successes achieved, and the lessons learnt.
Methods: An initial scoping visit to Liberia was followed by three further on-site visits. Problems iden-
tified were: very limited or no network and computer resources, no internet connection, intermittent
power, and lack of IT skills. We followed an evolutionary approach to infrastructure implementation by
trying various solutions before settling on an offsite-hosted solution using Software as a Service (SaaS).
Local staff were upskilled to administer this while remote support from Stellenbosch IT was provided.
A stable internet connection was established. Staff and students can access the Learning Management
System (LMS) 24/7 using mobile devices and laptops. Workshops were held where staff were taught how
to produce online teaching material. Each class has at least one teaching assistant to assist lecturers with
uploading and indexing material on the LMS.
A benchmarking visit by COHLS faculty to Stellenbosch University took place, during which an e-learning
strategic plan was drawn up. Further online workshops were conducted, and teaching materials were
placed on the new LMS.
Outcomes: The intranet that was established consisted of internet connection and software as a ser-
vice in the form of Office 365, providing access to several products and services. The e-learning model
attended to technology and human resources simultaneously. The e-learning strategy aimed to improve
teaching and learning at the COHLS, boost the number of qualified doctors, reduce the workload on lec-
turers, and be scalable in the future.
Conclusion: It is challenging to implement e-learning in medical education. Inadequate infrastructure,
limited bandwidth, lack of skilled IT staff, unreliable power supply, time commitment, and ongoing main-
tenance all need to be overcome. The creation of an e-learning solution for the COHLS over a period of
15 months was enabled by the common vision and close collaboration of the three partners. This model
can potentially be replicated across other faculties in the University of Liberia and other educational
institutions in Liberia.
Background ing institutions remained, which had limited resources
Liberia’s health workforce has faced challenges since the and few academics [1]. Several reforms were instituted
late 1970s when the country’s economic growth slowed, under the Sirleaf administration after 2006 to address
and people emigrated in search of better opportunities. health workforce shortages, including the reintroduction
The civil war from 1989–2003 left the health system dev- of free medical education. These strategies resulted in an
astated, destroying infrastructure and causing healthcare increase in the numbers of healthcare workers trained,
worker shortages. In 2006, there were 20 physicians left in but there remained a maldistribution of healthcare work-
Liberia, as opposed to 237 before the war. Only a few train- ers between rural and urban areas [1].
During the rebuilding of the health workforce, the
* Faculty of Medicine and Health Sciences, Stellenbosch Ebola virus epidemic struck in 2013. Health workers
University, ZA were disproportionally affected by the epidemic with
†
College of Health and Life Sciences, University of Liberia, LR deaths reported in two-thirds of those health workers that
Corresponding author: Dr S. Walsh, MBChB, MMed, DipData(INF), became infected [2]. The country’s Investment Plan for
MSc (Health Informatics) (dr.steve.walsh@gmail.com) Building a Resilient Health System in Liberia 2015–2021
Walsh et al: E-learning for Medical Education in Liberia 191
highlighted the government’s priorities in rebuilding which may be useful to other training institutions in
the health system to ensure it has the capacity, not only resource-constrained environments.
to provide the expected essential health services for the
people of Liberia, but also to identify and appropriately Methods
respond to future health threats [3]. An initial scoping visit took place in February 2016 and a
In 2016, the number of registered medical practitioners Memorandum of Understanding between Stellenbosch
in active practice in Liberia was 165. This translated into University (SU) and the UL was signed. This was followed
a doctor/patient ratio of 1:25,000 (population 4,000,000) by three further visits to conduct training workshops in
as compared to the World Health Organization recom- Monrovia and install the IT hardware and software (May
mended ratio of 1:15,000. 2016, October 2016, and May 2017). A benchmarking visit
There is one medical school in Liberia, namely the to the SU Faculty of Medicine and Health Sciences (FMHS)
College of Health and Life Sciences (COHLS), previously by a delegation from the COHLS took place in November
the AM Dogliotti School of Medicine (AMDCM), at the 2016, during which an e-learning strategic plan for the
University of Liberia (UL), in Monrovia. The college has COHLS was drawn up. Online workshops were conducted
a five-year medical pre-service program modelled on the for lecturers during January 2017. A collection of clinical
United States of America’s training model. The AMDCM videos and other teaching material was placed on the new
has graduated 392 medical practitioners since its incep- SharePoint server, which has a specially programmed inter-
tion in 1968, with continued growth in the past ten years face that functions as a learning management system (LMS).
[4]. The current average output is 40 medical graduates
per year [3]. The total student enrolment for 2015–2016 Baseline Visit (February 2016)
was 201 students [4]. There are 31 instructors at the The baseline visit followed a series of communications
College, of which about 50% are part-time [4]. between the COHLS, SU and HRSA. A programme was set
Curriculum renewal and upscaling of student numbers for the visit but had to be adapted due to the realities at
poses a particular challenge on the African continent, the host institution. At the time, there was no internet
given its inordinate burden of disease and critical short- connection at the COHLS, but about 79% of the lectur-
age of healthcare professionals and medical teachers [5, ers and students had a laptop or personal computer (PC).
6]. There is therefore an urgent need to strengthen both There was no Wi-Fi in the teaching complex or student
the educational facilities and enable the teaching faculty residences. Many students lived off-campus, also with lit-
to provide relevant and quality medical education [7, 8]. tle internet access. There were around 70 refurbished lap-
There is literature suggesting that e-learning can address tops that were meant to be used by the students. There
barriers to training and improve retention of health work- was one part-time information technology (IT) person on
ers [9]. Using e-learning in medical education helps pro- site for the faculty.
vide relevant learning opportunities for students, as well Although some basic infrastructure was initially in place
as developing faculty competencies [9]. (Table 1), most of the whiteboards were unusable due to
SURMEPI formed part of the greater MEPI initiative to bad surface cracks, and the data projector was seldom
improve human resources for health in Africa [6]. SURMEPI used. Table 1 provides a list of the COHLS existing equip-
developed innovative medical education models in order ment and facilities in February 2016.
to strengthen medical education and health systems in The dean (Prof Golakai) identified three main priorities
rural and resource-constrained environments [10]. One of during the baseline visit:
these models was the development and implementation
of e-learning in medical education [11, 12]. As a result, the • Faculty were to be introduced to e-learning and as-
COHLS approached SURMEPI to assist them to create an sisted to develop their own electronic lesson material;
e-learning solution for them. • Students needed access to electronic textbooks both
The objective of this article is to outline the develop- while studying and after graduation;
ment and implementation of an e-learning solution for • Internet connectivity to remote hospitals would be
the COHLS. Key successes and lessons learnt are described, useful for telemedicine (so a doctor can get assis-
Table 1: Existing Equipment and Facilities (Feb 2016).
Facility Capacity Existing Equipment
Auditorium (main lecture room) Seating for 50 to 60 students Whiteboard. Data projector only on request
Annex Classrooms (3) Seating for 20 to 30 students Whiteboards with badly cracked surfaces
Students’ Computer Laboratory Twenty PCs on an intranet Running Linux with OpenOffice
Lecturers’ Computer Laboratory Five PCs on an intranet Running Linux with OpenOffice
Dell Server 72 terabyte storage Moodle with some lesson content (not regularly updated)
Wi-Fi Network Not functioning
Library About 6,000 medical and phar- Manual stock and loan system. Open from 8 am to 4 pm
macy books weekdays only
192 Walsh et al: E-learning for Medical Education in Liberia
Figure 1: Proposed E-learning Infrastructure.
tance with clinical cases) and to be used for staying After thoroughly exploring various options including
up-to-date. cellular, satellite, and microwave links, last-mile internet
was secured through PowerNet, who provided a 10-mega-
Proposed Solution to Support E-learning byte fully redundant connection. They were directly linked
At the end of the baseline visit, it was clear that the to ACE and offered continuous support all year round.
infrastructure required for the COHLS needed the input Communication with distant hospitals could be facilitated
of a systems architect. A senior systems analyst from SU in the future as the company had ample experience with
was then brought on board. At this stage, the plan was satellite connections and could assist with connecting
(Figure 1): remote locations.
A Wi-Fi network connected to the internet was installed
• To establish an internet connection; and covered the lecture halls and administrative building.
• To install a server which could be remotely configured The signal was strong enough for staff and students to
and controlled; be able to have internet access from the buildings across
• To acquire Microsoft Office 365 [13] licenses for stu- the road from the annex (i.e. the Physiology and Anatomy
dents and lecturers; laboratories).
• To use TechSmith Relay [14] for screen casting lec-
tures (subsequently dropped as the lack of on-site IT Installing the Hardware and Software
expertise became apparent); Much of the equipment had to be acquired outside of
• To enable videoconferencing. Liberia and couriered to the country. This necessitated
engaging with complex procurement and delivery systems
The intention was to turn the college into an e-teach- in the sending country and import control regulations in
ing and e-learning environment and upskill all IT staff, Liberia. The equipment had to be classified as donated to
lecturers and students. This required access to email, comply to import tax regulations.
authenticated login, cloud backup, Windows, all Microsoft Four data projectors were permanently installed in the
programs and other software. The expertise to run much lecture rooms – a major undertaking that took more than
of this would be supplied remotely by SU IT, thus address- a week to accomplish. All the power plugs in the main
ing the lack of IT skills available locally at the time. It was auditorium and three annex classrooms were replaced,
important to implement the system in small steps to as most were not functioning. Students could then bring
determine what worked and what did not. Implementa- their laptops to class and take notes during lectures.
tion was planned as a phased approach consisting of three Crack-filler for wall defects, primer, brushes and special
visits to COHLS, during which time equipment was sup- white paint for coating the projection walls in the class-
plied, installed, configured, and tested. At the same time, rooms were supplied to renovate facilities. Pilot testing of
capacity development workshops were conducted for the videoconferencing facility in the Lecturers Laboratory
lecturers and students. Much configuration of the equip- over the internet connection worked well during the on-
ment was done remotely once the COHLS was connected site visits. Table 2 lists the hardware and software that
to the internet. Training was provided for the local IT staff. was installed at the COHLS over 12 months.
Installing the Internet Connection Capacity Building Workshops
During the civil wars, most of Liberia’s communications Initially there was poor understanding of e-learning and
infrastructure was destroyed, so fixed landlines (digital little familiarity with software, although most had used
subscriber lines) could not be used. Cell phone coverage Microsoft Office (Word and PowerPoint) to some degree.
in Monrovia was reasonable through three main suppli- Over the twelve months of the project, eight workshops
ers (LibTelco, CellCom, and LoneStar). Cellular data was on various e-learning topics were held during each of
expensive and sometimes not available even in urban the three site visits (workshops were duplicated to allow
areas. more to attend). These were run while the IT equipment
Liberia is connected to the Africa Coast to Europe was being installed. Three additional online workshops
(ACE) fibre-optic undersea cable that comes aground were also done. The aim of the workshops (Table 3) was
in Monrovia and is controlled by a public-private group to make lecturers comfortable with using technology for
called the Cable Consortium of Liberia. Because of the both synchronous and asynchronous teaching. A total of
high bandwidth costs and the unavailability of funds, the 160 participants attended the workshops (approximately
UL had no permanent internet connection. 70% lecturers and the rest teaching assistants/senior
Walsh et al: E-learning for Medical Education in Liberia 193
Table 2: ICT Infrastructure Installed (May 2016 to May 2017).
Hardware Software
Dell PowerEdge Server, uninterruptable power supply (UPS) and Microsoft Office 365 licenses for 450 students and lecturers.
switch.
Five data projectors (one for each lecture room and one spare) Special interface in SharePoint to simulate a LMS.
with five spare bulbs.
55-inch monitor screen mounted on the wall of Lecturer’s SharePoint configured with COHLS course outline struc-
Laboratory. ture and populated with existing as well as new e-learning
content.
Jabra omnidirectional microphone and Logitech webcam. CmapTools [15] (Concept map).
Lecture hall loudspeaker system consisting of two remote hand-
held microphones, internal battery supply, Bluetooth connec-
tions and internet connectivity.
Table 3: Workshops.
Workshop Topic Software Used Application for the COHLS
Concept Mapping for CmapTools Empowers users to construct, navigate, share, and criticize knowledge models
Knowledge Transfer represented as concept maps. Attendees got practical experience on how to create
concepts maps of their lectures. These can be used by lecturers for teaching and
evaluation and by students for learning.
Creating Sreencasts/ Office 2013 or Attendees got practical experience on creating their own screencasts/videos of their
Videos Using Power- 2016 with Power- lectures using PowerPoint. We covered some PowerPoint’s basics and progressed
Point Point to recording the lecturer’s voice over their slides. Each person was given a headset
microphone. We concluded with producing a screencast or video of a PowerPoint
lesson.
Finding Evidence- Laptop with a Hands-on experience on how to find evidence-based information on the internet.
based Medical browser and inter- The workshop covered Boolean logic and progressed to using Medical Subject Head-
Information on the net connection. ings (MesH) for retrieving results from PubMed and its related medical databases.
Internet We concluded with an overview of a wide range of open source online journals.
Using OneNote and Microsoft OneNote Lecturers and Teaching Assistants were taught to use the tools on Office 365 in
Class Notebooks and Class Note- for creating online lessons for uploading to their LMS. Online sources of free,
book peer-reviewed medical courses were also evaluated for possible inclusion in their
modules.
Medical Apps for Online workshops Lecturers attended the online workshops on using various useful apps on their
Your Smartphone with supporting smartphones to support patient care. Several apps were demonstrated, including a
PDF and video. drug database and HIV treatment guidelines.
students). All lecturers/module chairs were expected to the content and approaches that were conveyed during
attend and computer-literate students from each class the workshops.
were selected for training. In addition to these workshops, The lecturers wanted further workshops but due to
regular training sessions were held for the COHLS IT sup- unfamiliarity with the range of possibilities, struggled
port person at least once weekly throughout the entire to suggest their own topics of interest. As medical apps
project. for a smartphone could be extremely useful, a video was
The workshop participants brought their own laptops. created documenting various medical apps, which was
Browsers and Office suites were upgraded an additional uploaded to the SharePoint LMS site as an example of
software such as concept maps (CmapTools) [15] installed. online content [16].
It was evident in the workshops that the level of computer Anonymous online surveys conducted after the work-
literacy in faculty was initially generally low. This was shops was positive. Participants felt the content was well
attributed to the lack of a Wi-Fi network, expensive data presented and that the practical demonstrations and
and no internet connectivity. Most had outdated operat- hands-on approach was helpful to master key IT skills.
ing systems and Office products. Few participants used a They would recommend the workshops to colleagues
mouse, which lead to difficulties in working with complex and intend to use what they learnt in their workplace.
programmes such as creating Cmaps. It was not easy to The participants wanted more time for the workshops
schedule workshop times as potential attendees were very and requested regular refresher courses going forward. In
busy and weekends were inconvenient. Figure 2 shows terms of the online workshops, they were satisfied with194 Walsh et al: E-learning for Medical Education in Liberia
Figure 2: Capacity Building Workshops.
the support received and that the video-conferencing SharePoint server (or any internet resource) any time of
facilities worked well. the day or night. They also have access to Office 365 on
their PCs, laptops, or smartphones and can download the
Benchmark Visit (November 2016) full Office 2016 suite. Learning material can be stored in
Ten delegates from the COHLS visited the FMHS at SU in the cloud (on OneDrive), or downloaded locally and taken
South Africa during November 2016. Apart from the lec- off campus. See Figure 4.
turers, the delegation included both the interim dean and
the recently retired dean, a medical student and a post- The Strategic Plan
graduate student. SU FMHS e-learning facilities were vis- The strategic plan for e-learning at the COHLS envis-
ited and various activities and strategies for e-learning in aged that the implementation of the e-learning strategy
medical education were discussed with the delegation. A would improve teaching and learning at the COHLS with
full day was devoted to developing a strategic plan for the outreach to other parts of Liberia, create IT competent
implementation of e-learning at the COHLS. COHLS end-users, and propel the COHLS and UL into the
digitalized 21st century. Strategies that were set out to
Outcomes achieve these outcomes were the following:Perform cur-
Office 365 Functionality for the COHLS riculum content and delivery review to enable the use of
The intranet that was established at COHLS had an inter- e-learning.
net connection and “software as a service” (SaaS) in the
form of Office 365, providing access to several products • Identify and use instructors and student peers to
and services with a single sign-on. This approach was teach IT skills and content creation.
important in a resource-constrained environment as it • Make technology affordable and accessible to stu-
reduced the need for specialised on site IT skills, whilst dents and lecturers.
still providing a first-world e-learning environment that is • Use online resources.
available to students and staff anywhere and at any time. • Motivate students and lecturers to use e-learning fa-
Figure 3 provides an overview of the Office 365 function- cilities.
ality that was now available to students and staff 24/7. • Take all new students through basic IT literacy train-
ing.
E-learning Model • Generate an online repository of learning and assess-
The e-learning model that was created for the COHLS tar- ment materials.
geted technology and human resources simultaneously.
Staff and students assimilated a variety of topics that ena- Discussion
bled them to use the new technology. Material from the The creation of an e-learning solution for the COHLS
workshops was uploaded onto the new LMS to be avail- over a period of 15 months was enabled by the com-
able for updating knowledge and skills. A local IT support mon vision and close collaboration of the three partners
person was equipped to maintain the new system. All (COHLS, SU and HRSA). There was enthusiastic buy-in
students and staff at the COHLS now have free access to from the UL and the COHLS. All the work done was based
the internet at the medical campus. This allows them to on COHLS priorities and adapted to suit the local con-
access and download the teaching material on the LMS text. The COHLS has made a quantum leap forward inWalsh et al: E-learning for Medical Education in Liberia 195 Figure 3: Overview of Office 365 Functionality for the COHLS. Figure 4: The E-learning Model.
196 Walsh et al: E-learning for Medical Education in Liberia
Table 4: Lessons Learnt.
• Close collaboration is needed more so when there are communication challenges.
• Mainstream funding for maintenance and repairs should be made available.
• Expensive bandwidth needs to be addressed by a National Research and Education Network (NREN).
• A knowledgeable and reliable internet service provider is essential.
• A reliable power supply is a priority as the lack of a stable power supply could severely compromise the impact of e-learning
interventions.
• Capacitating a local on-site person to support and maintain the e-learning model is crucial.
• The level of computer literacy needs to be assessed.
• Capacity building training should be adapted to address various levels of competencies.
• Time for workshops should be reserved as people have busy schedules.
• Getting to know the issues that really matter to local staff and students is essential as they can be unfamiliar with various
e-tools and e-learning.
terms of their IT equipment, internet connectivity, and critical success factors, namely socio-cultural, infrastruc-
students’ and staff’s IT capacity. The COHLS now have tural, political and leadership, legal and regulatory, eco-
a functioning e-learning system and a strategic plan to nomical, educational and skills, security and safety, and
take them forward. Staff and students have continuous technical [19]. Infrastructural and economic constraints
access to the internet and LMS. Videoconferencing, email posed the biggest obstacle in their case study, but all
addresses, and personal cloud storage accessible by PC these factors need attention. They found country-specific
or smartphones are all freely available. This model can differences in the occurrence of the other factors, which
potentially be replicated across UL and other teaching emphasizes the importance of adapting to the context
institutions in the country. when implementing e-learning.
It is challenging to implement e-learning in medical The success of e-learning greatly depends on good infra-
education, not only in lower middle-income countries structure that delivers services and makes them readily
(LMICs) [9]. Inadequate infrastructure, limited bandwidth, accessible, which requires a large investment as well as
lack of skilled IT staff, time commitment, and mainte- continuous maintenance [9, 19]. A larger and more highly
nance of e-learning are all factors that demand attention trained workforce is needed who have hardware, software,
[9]. Daily power outages in Monrovia disrupted commu- and e-learning training skills. Several valuable lessons
nication, impeded on the availability of internet for staff were learnt during the planning and implementation of
and students and was potentially damaging to electronic this project (Table 4). These lessons can be of use for set-
equipment. Close collaboration was needed to overcome ting up e-learning platforms in similar contexts.
communication challenges.
Sustainability is a major consideration as the high cost Conclusion
of internet access is a potential problem. It is a priority for The e-learning model at the COHLS has been successfully
educational institutions in Liberia to establish a National introduced, but the endeavour is not yet self-sustaining.
Research and Education Network (NREN), which is usually It was vital to get the infrastructure installed correctly
a non-profit organization functioning with government and configured so that the model can be expanded seam-
backing but working independently to negotiate band- lessly. The exciting possibility exists to expand the model
width prices with internet service providers. Two fibre- to the rest of UL with its approximately 46,000 registered
optic undersea cables could be used, namely the ACE or students. Establishing, maintaining, and expanding an
the WACS (West Africa Cable System). A group to the east e-learning environment at the entire COHLS is a com-
of Liberia called WACREN [17] (West and Central African plex task that requires a dedicated team who possess an
Research and Education Network) uses the WACS inter- array of technical skills. The team should include care-
net connection. Recently Sierra Leone took its first steps fully selected consultants whose special expertise can be
toward establishing an NREN [18]. NRENs have proven called on when required. The long-term benefits for the
successful in driving down the cost of internet for educa- Liberian healthcare system are potentially enormous, and
tional and research purposes, possibly by 50% or more. the model used at the COHLS could be emulated at other
Recently Google has been appointed to create a fibre- educational institutions in Liberia.
optic ring around Monrovia but commercial concerns pre-
vent the COHLS from benefiting. Acknowledgements
The Office 365 licence fees need to be paid annually. The UL welcomed the team to their country and campus.
Fortunately, being an educational institution means that Wielligh Lambrechts assisted as senior systems analyst
the UL can obtain this at a greatly reduced fee. It would be consultant. Suzaan Sutherland procured and shipped all
good to get other departments at UL to use the same plat- the equipment. Debbie Harrison handled the financial
form as much as possible to reduce cost due to duplica- requisitions and logistics for the site visits. Eugene Bau-
tion. It is best to use hosted services (such as SaaS) where gaard dealt with the management of the grant. José Rafael
possible given the lack of local expertise. Morales provided funder-related assistance and liaison.
Touray et al. identified 43 barriers in implementing ICT Athol Kent edited the manuscript. The study was funded
in LMIC countries [19]. These were grouped into eight by the President’s Emergency Plan for AIDS relief (PEPFAR)Walsh et al: E-learning for Medical Education in Liberia 197
through the Health Resources and Services Administra- 6. Mullan F, Frehywot S, Omaswa F, et al. The Medi-
tion (HRSA) under the terms of T84HA21652. cal Education Partnership Initiative: PEPFAR’S effort
to boost health worker education to strengthen
Funding Information health systems. Health Aff. 2012; 31(7): 1561–1572.
The study was funded by the President’s Emergency DOI: https://doi.org/10.1377/hlthaff.2012.0219
Plan for AIDS relief (PEPFAR) through Health Resources 7. Chen C, Buch E, Wassermann T, et al. A sur-
and Services Administration (HRSA) under the terms of vey of Sub-Saharan African medical schools. Hum
T84HA21652. Resour Health. 2012; 10(1): 4. DOI: https://doi.
org/10.1186/1478-4491-10-4
Competing Interests 8. Mullan F, Frehywot S, Omaswa F, et al. Medi-
The authors declare that they have no financial or per- cal schools in sub-Saharan Africa. Lancet.
sonal relationship(s) that may have inappropriately influ- 2011; 377(9771): 1113–1121. DOI: https://doi.
enced then in writing this article. All authors had access to org/10.1016/S0140-6736(10)61961-7
the data and a role in preparing the manuscript. 9. Frehywot S, Vovides Y, Talib Z, et al. E-learn-
ing in medical education in resource con-
Author Contributions strained low- and middle-income countries. Hum
Dr Walsh led the implementation of the project, wrote the Resour Health. 2013; 11(1): 4. DOI: https://doi.
first draft of the manuscript, and assisted in editing vari- org/10.1186/1478-4491-11-4
ous further versions. Prof de Villiers managed the project 10. De Villiers M and Moodley K. Innovative strategies
as the SURMEPI principal investigator and assisted in edit- to improve human resources for health in Africa:
ing several versions of the manuscript. Prof Golakai, the The SURMEPI story. African J Heal Prof Educ. 2015;
dean of the College of Health and Life Sciences at the time 7(1): 70.
when this work was done, conceptualised the project, pro- 11. De Villiers M, Walsh S, Int M and Informatics H.
vided information for the manuscript, and led the devel- How podcasts influence medical students’ learning.
opment of the e-learning strategic plan. All authors read African J Heal Prof Educ. 2015; 7(1): 130–133.
and approved the final manuscript. 12. Walsh S and De Villiers M. Enhanced podcast-
ing for medical students: Progression from pilot to
References e-learning resource. African J Heal Prof Educ. 2015;
1. Varpilah ST, Safer M, Frenkel E, et al. Rebuild- 7(1): 125–129.
ing human resources for health: A case study 13. Office 365. https://www.office.com/ Accessed
from Liberia. Hum Resour Health. 2011; 9(1): 11. May 17, 2017.
doi: 10.1186/1478-4491-9-11. DOI: https://doi. 14. TechSmith Relay. https://www.techsmith.com/
org/10.1186/1478-4491-9-11 techsmith-relay.html Accessed May 17, 2017.
2. World Health Organization (WHO). Health 15. Cmap Tools. http://cmap.ihmc.us/ Accessed May
worker Ebola infections in Guinea, Liberia and 17, 2017.
Sierra Leone – A preliminary report. 2015 May; 16. Medical Smartphone Apps. https://universityli-
1–16. Accessed May 17, 2017. beria.sharepoint.com/sites/healthsciences/quick-
3. Liberia Ministry of Health. Investment Plan for startLMS/Lecturer/SmartphoneApps/MedicalSm
Building a Resilient Health System: 2015–2021. artphoneApps(1440x1080).mp4 Accessed May 17,
2015 May; 1–60. Accessed May 17, 2017. 2017.
4. Golakai V. Personal communication by Prof V 17. WACREN. http://wacren.net/ Accessed May 17, 2017.
Golakai, previous Dean of the College of Health and 18. NREN in Sierra Leone. https://indico.wacren.net/
Life Sciences, Monrovia, Liberia; 2016. event/33/ Accessed May 17, 2017.
5. Greysen SR, Dovlo D, Olapade-Olaopa EO, 19. Touray A and Salminen A. ICT barriers and criti-
Jacobs M, Sewankambo N and Mullan F. Medical cal success factors in developing countries. Electron
education in sub-Saharan Africa: A literature review. J Informations Syst Dev Ctries. 2013; 56(7): 1–17.
Med Educ. 2011; 45(10): 973-986. DOI: https://doi. DOI: https://doi.org/10.1002/j.1681-4835.2013.
org/10.1111/j.1365-2923.2011.04039.x tb00401.x
How to cite this article: Walsh S, de Villiers MR and Golakai VK. Introducing an E-learning Solution for Medical Education in
Liberia. Annals of Global Health. 2018; 84(1), pp. 190–197. DOI: https://doi.org/10.29024/aogh.21
Published: 30 April 2018
Copyright: © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons
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